Healthcare Provider Details

I. General information

NPI: 1124392808
Provider Name (Legal Business Name): DAMIAN ROBERT OCHOA MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2012
Last Update Date: 02/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1899 MISSION ST
SAN FRANCISCO CA
94103-3501
US

IV. Provider business mailing address

1899 MISSION ST
SAN FRANCISCO CA
94103-3501
US

V. Phone/Fax

Practice location:
  • Phone: 415-226-1775
  • Fax: 415-503-2223
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number32445
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: